With better availability of assisted reproductive technique and its success more and more infertile couples are being assisted to accomplish their dream of parenthood. Assisted reproductive technique (ART) may affect the outcome of pregnancy which may be related to the infertile condition itself or to the technique used. There is some evidence that ART affects the perinatal outcome, the mode of delivery and the early childhood up to some extent, but this may or may not be that significant. This chapter covers the risk of multifetal gestation and management of art pregnancies. With ART, the incidence of multifetal gestation goes up significantly. Multiple gestations itself is associated with higher maternal and fetal morbidity as well as mortality. The perinatal risk increases disproportionately with number of fetus and monozygosity.